Temporary Drainage Clamping After Total Knee Arthroplasty: A Meta-Analysis of Randomized Controlled Trials
Section snippets
Materials and Methods
We followed the methodological guidelines outlined by the Cochrane Collaboration (Oxford, UK) [28] to conduct this meta-analysis. The findings were reported according to the recommendations outlined in the Quality of Reporting of Meta-Analyses statement [29].
Identified Trials
A total of 1653 articles were retrieved in the search. Ten randomized controlled trials comparing various clamping methods and conventional drainage were identified. Two studies dealing with a comparison between different clamping methods were excluded. Another 2 studies were excluded because of missing data or a poor quality of methodology 16, 19. The remaining 6 studies were included in the meta-analysis (Table 1). The authors of 2 articles 18, 21 provided additional data after contact. These
Discussion
The use of closed suction drains in TKA is a common practice, although it has been questioned, and the effect of clamping the drain tube is also not clear. Several reports with varying results regarding the delayed release of the drain have been published in the last decade. Therefore, we conducted a systematic review of the literature and subsequent meta-analysis of the results. Our present study could not provide enough evidence to support the application of temporary clamping of the drain
Acknowledgment
The authors would like to thank Miss Windy Chia-Jung Ho for the excellent assistance.
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Cited by (44)
Should we routinely perform a post-operative hemoglobin check following unicompartmental knee arthroplasty?
2020, KneeCitation Excerpt :Topical application of fibrin sealants and bipolar sealant electrocautery has been reported to reduce blood loss following TKA [61,62], this however, was not investigated in our study. Post-operative factors include the avoidance of surgical drains; which have been shown to increase post-operative blood loss [63–65]. Compression dressings and cryotherapy have been utilized to attempt to reduce blood loss after TKA, the evidence for reducing blood is equivocal [66–68].
Pillars in the blood conservation
2016, Revista Chilena de CirugiaTranslating evidence-based protocol of wound drain management for total joint arthroplasty into practice: A quasi-experimental study
2016, International Journal of Orthopaedic and Trauma NursingCitation Excerpt :After the next measurement on the third postoperative hour, it appeared that the drain clamping was effective in reducing blood loss during the early phase. A meta-analysis of Randomized Controlled Trials relating to temporary drainage clamping after total knee arthroplasty resulted in a decrease in the volume of drainage, if only clamping for more than at least four hours could reduce the true blood loss (Tai et al., 2010a). In this study, blood loss was not significantly reduced in the protocol group and no adverse outcomes from haematoma formation were noted.
Leg position influences early blood loss and functional recovery following total knee arthroplasty: A randomized study
2015, International Journal of SurgeryCitation Excerpt :Knee flexion at 90° after TKA with the intraoperative use of TXA is an effective method to reduce blood loss and the need for blood transfusions [18]. Drain clamping can decrease the volume of drainage, but to reduce blood loss, the clamp must be kept in place for at least 4 h [27]. Intra-articular drainage for 48 h offers no significant advantage over drainage for 24 h [28].
Role of drain in early clinical outcomes following primary total knee arthroplasty
2018, Journal of Arthroscopy and Joint SurgeryCitation Excerpt :Nonetheless, use of a drain following TKR may result in increased blood loss, need for transfusion7,8 and retrograde infection.9–11 To reduce such risks, the use of a clamping drain,12,13 reduction in the drainage duration9–11 and suction pressure,14,15 and auto transfusion of drained blood16,17 are suggested. Between July 2016 and November 2017, a prospective cohort of consecutive series of 61 women and 39 men (mean age, 66 years) with primary osteoarthritis of knee underwent unilateral TKA under spinal anaesthesia using Zimmer Natural Knee system II.
No benefits or funds were received in support of the study.